Performance Improvement 1999. Prevention Services


TITLE: Evaluation of Tuberculosis Outreach Worker Activities

ABSTRACT: In 1987, the Advisory Committee for the Elimination of Tuberculosis (TB) urged the Nation to establish the goal of TB elimination by the year 2010. Recommended strategies for the control of TB included increasing funding for outreach workers (ORWs) and for outreach activities. This project sought to answer three evaluation questions: (1) What activities do outreach workers perform? (2) In carrying out these activities, how do TB outreach workers interact with other health care personnel and patients? (3) What factors influence the effectiveness of TB outreach worker activities? The report finds that: (1) On the whole, ORWs spent significantly more time providing direct and support outreach services in the field than in clinical settings. (2) ORWs who participated in the study were familiar with the cultures and spoke the languages of the populations to which they provided services. (3) The ways in which the ORWs interacted with one another and the nature of their relationships reflected the social organizations and interpersonal dynamics of the different study locations and specific health care settings. (4) The ORWs often treated patients and their relatives with consideration and even personal concern. In addition, ORWs, their supervisors and patients indicated the kinds of knowledge and skills, and the attitudes and attributes that they thought TB ORWs should possess in order to be effective. The report recommends these characteristics, as well as increased and improved ORW training in patient interaction, interviewing techniques, and report writing. These characteristics can serve to inform TB control programs that are seeking to recruit appropriate individuals for ORW positions. (Final report 57 pages plus appendices.)

AGENCY SPONSOR: National Center for HIV, STD, and TB Prevention

FEDERAL CONTACT: Zachary Taylor, M.D.

PHONE NUMBER: 404-639-6201

PIC ID: 5502

PERFORMER ORGANIZATION: Casals and Associates Arlington, VA

TITLE: Project to Assess the Feasibility and Need for Support of Cervical Cancer Screening in Public STD Control Clinics

ABSTRACT: This report presents the results of the first phase of a three-phase project sponsored by the Centers for Disease Control and Prevention (CDC) to assess the feasibility and need for support of cervical cancer screening in publicly-funded sexually transmitted disease (STD) control clinics. Site visits were conducted of nine STD clinics to explore the availability, adequacy, and usefulness of data elements in addressing the research questions. The report finds that: (1) the number of patients seen in each clinic ranged from about 70 per month to 1,929; (2) women make up between 30 and 50 percent of STD clinic clientele, and approximately 40 to 90 percent of those were first time patients; (3) no reliable information could be gathered on where and when women seen in STD clinics received Pap testing; (4) there is wide variability in the collection and management of information among the STD clinic sites; (5) staffing patterns in the STD clinics correspond to particular functions (intake, education and counseling, examination and tracking, follow up and referral); and (6) there is agreement among the literature and the people interviewed that patient education is important in a cervical cancer screening program . The report concludes that it is feasible to carry out cervical cancer screening in public STD clinics, but the information systems necessary to demonstrate the need for this activity are lacking. The report recommends the implementation of a demonstration project, so that further information can be developed concerning the use of STD clinics for reaching women who may not be receiving Pap testing, an important public health measure for the prevention of cervical cancer. (Final report 102 pages; Site reports 119 pages.)

AGENCY SPONSOR: National Center for Chronic Disease Prevention and Health Promotion


PHONE NUMBER: 770-488-4976

PIC ID: 6705

PERFORMER ORGANIZATION: Battelle Corporation Arlington, VA